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Öğe Extracellular Histones H3 as a Prognostic Blood Marker for Delayed Liver Function Recovery After Donor Hepatectomy(Elsevier Science Inc, 2021) Novruzov, Namig; Ersan, Veysel; Bayramov, Nuru; Otlu, Baris; Aliyev, Eldar; Ince, Volkan; Isik, BurakBackground. Early prediction of liver dysfunction after liver resection remains a challenge. We hypothesized that extracellular histone concentrations are a promising new biomarker for the detection of liver injury after donor hepatectomy. Methods. This prospective study considered 93 living donors who underwent hepatectomy. Blood samples of donors were collected on postoperative day 1, and histone levels in the plasma samples of the patients were measured with total histone H3 sandwich ELISA kits. Among 86 right lobe donors, 23 (26.7%) were deemed to have a delayed liver function recovery according to the International Study Group of Liver Surgery's definition of posthepatectomy liver failure, whereas 63 (73.3%) were considered to have an adequate liver function recovery. Results. The area under the receiver operating characteristic (ROC) curve for circulating histo-nes in predicting persistent liver dysfunction was 0.618 +/- 0.06 (95% confidence interval [CI], 0.501-0.735; P = .091). The cutoff point value obtained from the analysis of ROC curves was 0.895, with a sensitivity of 95.7% and a specificity of 32.9%, respectively, for examining a delayed liver function recovery (P = .015). The Fisher analysis significantly verified these results empirical influence function % 7.90 (95% CI, 3.91-11.90; P = .006). The univariate analysis determined that postoperative histones were identified as an independent risk factor of delayed liver function recovery (odds ratio, 10.8; 95% CI, 1.4-84.9; P = .024). Conclusions. The circulating histone negatively correlates with liver dysfunctions after donor hepatectomy and had the best value in predicting liver dysfunction within 24 hours after liver resection.Öğe Liver Graft and Spleen Elastography After Living Liver Transplantation: Our First Results(Elsevier Science Inc, 2019) Bayramov, Nuru; Yilmaz, Sezai; Salahova, Sevinj; Bashkiran, Adil; Zeynalov, Nadir; Isazade, Elvin; Bayramova, TeraneAim of the study. Liver transplantation is widely applied as a standard and effective management of end-stage liver diseases, hepatocellular carcinoma, and acute liver failure. Investigation of morphologic and functional changes in the transplanted graft, gastrointestinal system, and spleen after transplantation is an important ground for assessment of post-transplantation results, early changes related to complications, and evaluation of response to treatment modalities. The aim of this study was to investigate the dynamics of changes in elastography of the liver graft and spleen after living-related liver transplantation. Material and methods. The study included 14 cirrhotic patients after living-related liver graft transplantation. Stiffness of the spleen and liver was evaluated before transplantation and at 1, 3, and 6 months after transplantation with a Supersonic Aixplorer Multi Wave device. Each procedure consisted of measuring the density in 10 points (spots) of the organ. The final result was calculated as the mean value of successful measurements (must have been > 60% of all measurements) and expressed in kilopascals. Results. The mean value of the liver and spleen stiffness before transplantation was 27 kPa (14-31 kPa) and 51 kPa (38-92 kPa), respectively. The stiffness of the spleen gradually reduced after transplantation to 40.3, 35.4, and 24.1 kPa (P = .001) at 1, 3, and 6 months. The stiffness of the liver graft in patients without complications was stable at 4-5 kPa, whereas the same value in patients with complications was increased (>= 7.5 kPa). In 5 patients, endoscopic investigation confirmed the significant reduction of varicose veins after surgery. Conclusion. Elastography of the liver graft and spleen after liver transplantation can be recommended as a useful-for-patient 1-off method of investigation.Öğe Living donor liver transplantation with replacement of vena cava for Echinococcus alveolaris: A case report(Elsevier Sci Ltd, 2014) Mamedov, Ruslan; Noyruzov, Namig; Baskiran, Adil; Yetisir, Fahri; Unal, Bulent; Aydin, Cemalettm; Bayramov, NuruINTRODUCTION: There is no medical treatment for alveolar echinococceal disease (AED) of liver till now. Curative surgical resection is optimal treatment but in most advanced cases curative resection can't be done. Liver transplantation is accepted treatment option for advanced AED. AED in some case invade surrounding tissue especially inferior vena cava (IVC). Advanced AED with invasion to IVC can be treated with deceased liver transplantation. Although living donor liver transplantation is very difficult to perform in patients with advanced AED with resected IVC, it come into consideration, since there is very few cadaveric liver. PRESENTATION OF CASE: Here we present a case with advanced stage of AED of liver which cause portal hypertension and cholestasis. AED invaded surrounding tissue, right diaphragm, both lobes of liver and retrohepatic part of IVC. Invasion of IVC forced us to make resection of IVC and reconstruction with cryopreserved venous graft to reestablish blood flow. After that a living donor liver transplantation was done. DISCUSSION: Curative surgery is the first-choice option in all operable patients with AED of liver. Advanced stage of AED like chronic jaundice, liver abscess, sepsis, repeated attacks of cholangitis, portal hypertension, and Budd-Chiari syndrome may be an indication for liver transplantation. In some advanced stage AED during transplantation replacement of retrohepatic part of IVC could be done with artificial vascular graft, cadaveric aortic and caval vein graft. CONCLUSION: Although living donor liver transplantation with replacement of IVC is a very difficult operation, it should be considered in the management of advanced AED of liver with IVC invasion because of the rarity of deceased liver. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd.Öğe TEMPORARY PORTOCAVAL SHUNT BY PIGGYBACK CAVA IN LIVER RE-TRANSPLANTATION(Wiley, 2013) Unal, Bulent; Mamedov, Ruslan; Ara, Cengiz; Aydin, Cemalettin; Bayramov, Nuru; Kayaalp, Cuneyt; Yilmaz, Sezai[Abstract Not Available]
